I've just spent about 56 hours in bed suffering different levels of abdominal pain, especially in my stomach and just underneath my ribcage. I've not been able to take anything by mouth, as fluids were brought back soon after hitting my stomach.

It's the first time I've had it since October, but I experienced it a number of times betwwen August and October and thought it was colic. I called out my GP on one occasion, when the pain was very severe, and it was he who diagnosed twisted bowel. Gary thought it might have been a partial blockage, but the new PMP research doctor, a senior moment I can't recall his name, said it was a twist caused by scar tissue and the mucine.

Fortunately my bowel is righting itself, but the advice is to take myself to A&E if the condition persists for longer than 72 hours, because of dehydration. I must admit I had plans for doing that in the night until finally I kept my first fluids down. What a relief. I'm still suffering some discomfort today and I'm feeling pretty tired.

I don't think many of you will have this experience, at least I hope not. I think it's part of the territory that comes with being a long time sufferer of the condition.

Love Chrissie

Replies: Posted By: Megs
Date Posted: 23 Jan 2008 at 1:29pm

Chrissie, Whilst I haven't experienced what you describle I too get pain beneath the rib cage (I do have hardening here) and stomach, I also get a feeling like a bulge below my rib cage which is quite hard but when I massage it the area starts to gurgle and eventually to bulge goes down.

Dr Shan (never know if I have his name right , he's the smiler) stated that it was either a twist caused following surgery or the disease pushing the bowel.

Thinking of you always Meirion

Posted By: Guests
Date Posted: 23 Jan 2008 at 5:55pm

Hi chrissie

hope you are feeling less pain today - what an awful event, my ribcage is distorted from the op one side, out over the stomach more than the other(luckily the boobs hide it!!!) but I do find that if I get a pain there and as Megs suggests just a gentle massage does seem to help. Do you take pain killers? It is difficult to know what to take sometimes I've jsut stuck to paracetemol but I have some stronger ones just in case, my GP is very good at making sure I have all the tablets I need!! Make sure you get a good supply.

Hope to hear from you soon when you are feeling a bit better.

love Liz xxxx

Posted By: rosie
Date Posted: 23 Jan 2008 at 9:23pm

Hi Chrissie.

I hope all is well again for you. It must have been awful for so long. I had similar symptoms for about a year and had the gurgling as meirion mentioned when it started to subside. But when it was really bad my doctor had prescribed buscopan and also i had a bottle of oramorph to hand although the buscopan seemed to do the trick most times. I was in agony at times and went a long time without sleep because of it. I never got to find out what caused it exactly, but got the same as you, twisted bowel ect.I really do sympathise with you and hope that it has now passed off. take it easy, get a bottle on your tummy and rest loads.

lots of love,

rosie xx

-------------Yesterday is history.
Tomorrow a mystery.
Today is a gift.
That's why it's called the present!
rosie xxx

Posted By: Sairdipops
Date Posted: 24 Jan 2008 at 9:42am

Hi Chrissie

Sorry that you have been uncomfortable and poorly. Hope everything is feeling much better soon.

xxxSarahxxx

-------------Que Sera Sera, whatever will be, will be..............

Posted By: Julie
Date Posted: 24 Jan 2008 at 1:01pm

Hi Chrissie

You poor luvie you sound like you have had it ruff over the last few days? I hope that you start to hold onto the fluids and start to feel a bit better soon and catch up on a little sleep if possible!

Thinking of you.

Julie xx

Posted By: Chrissie
Date Posted: 24 Jan 2008 at 4:55pm

Hi Meirion, Lizi, Rosie, Sarah and Julie

Thank you all for your concern. It's wonderful to know you're all out there rooting for me.

I feel much better today, though I'm still a bit listless and tired. I've started eating again, though I'm not enjoying the food yet, so I should start to get my strength back.

It's very difficult to take pain killers when you can't keep anything down. I did try, but with no success. I've had Buscopan in the past, but this is a whole different ball game. Fortunately the intensity of the pain is not constant, so I am aware that the severity will not last. That's what keeps me going.

I just pray that I can have a painfree period now before the next attack.

Love Chrissie xxx

Posted By: rosie
Date Posted: 24 Jan 2008 at 8:44pm

Hi Chrissie.

I am so pleased you are feeling a little better. I know its a long shot but if you are getting these attacks frequently have you tried taking the maximum amount of buscapan every day. (jeff's suggestion) whether or not you have the pain. Try it for a week and see if it helps stave off the attacks. I know when i got the pain it took a while for the buscapan to kick in and do the job and then i stopped taking them much to jeffs annoyance.

keep resting and try and enjoy your food. some choccies may be the order of the day and a good sleep.

love and best wishes,

rosie xx

-------------Yesterday is history.
Tomorrow a mystery.
Today is a gift.
That's why it's called the present!
rosie xxx

Posted By: Guests
Date Posted: 25 Jan 2008 at 4:11pm

Hi chrissie

Hope today has been a bit better again.

love Liz xx

Posted By: Chrissie
Date Posted: 25 Jan 2008 at 5:18pm

Hi All

Feeling much better today. Just got a bit of abdominal discomfort, nothing much more than the norm.

Rosie, I used to take Buscopan for my spastic colon, but haven't taken it for a while. I'll make an appointment with my GP and ask if he thinks it will stop the bowel twisting. I think I've just got a weakness there and it will happen periodically. The main thing is that it goes back of its own accord!

Love Chrissie xxx

Posted By: rosie
Date Posted: 25 Jan 2008 at 8:33pm

Hi Chrissie.

So pleased you are feeling much better. Have a restful week and i hope the doc's visit goes well and something can be given to ease your condition with the bowel.

love and best wishes,

rosie xx

-------------Yesterday is history.
Tomorrow a mystery.
Today is a gift.
That's why it's called the present!
rosie xxx

Posted By: maxine
Date Posted: 27 Jan 2008 at 7:59pm

Hi Chrissie

I have just read your post and was very sad to hear that you had that terrible pain - I do hope that you are feeling better and managing to keep some food down. Don't go overdoing things you will be very weak and tender - look after yourself and take care.

Love Max

xx

Posted By: Chrissie
Date Posted: 28 Jan 2008 at 9:40pm

Hi Max

Thanks for your good wishes.

I'm feeling fine again now. It's amazing how quickly you forget the pain once you are feeling comfortable again. Perhaps that is a good thing!

I've been out for a lovely walk this afternoon with a couple of friends and have caught up with the ironing and other jobs I could not do.

I hope all is well with you. Have you gone back to work yet?

Love Chrissie xxx

Posted By: maxine
Date Posted: 28 Jan 2008 at 9:58pm

Hi Chrissie

Glad you are feeling better and managed to get out today as it was such a georgeous day - far to nice to be inside.

As for work - they are being really good and I went back on the 27 December on a phased return for 3 weeks I have done 2 days (but not full days) and today I started 3 weeks of 3 days - but again not full days and it is being reviewed in 2 weeks to see how to progress from there.

I really now am going to tuck into that chocolate orange!!! It's a pitty they could not have done something about my chocolate addiction during the op!

Love Max

xx

Posted By: Chrissie
Date Posted: 29 Jan 2008 at 8:20pm

Hi Max

I'm pleased you're having a phased return, but please do not push yourself. Considerate bosses are wonderful!

Enjoy the chocolate orange and don't feel guilty! I've had two Ferrero Rocher and just thinking about a third!

Love Chrissie xxx

Posted By: Wendys Daughter
Date Posted: 12 Feb 2008 at 1:22pm

Hi, I'm Rachel and I'm new so bear with me if I am doing this wrong!! I am posting on behalf of my mum (Wendy) as she hasn't entered the current century so doesn't have a computer.

Mum went into Addenbrookes in Cambridge approx 4 years ago to have a tumour removed from her ovaries, a hysterectomy etc. When she came around (and was alone) the doctor told her she had a very rare cancer (PMP) and that it would keep growing and she would keep needing operations. This was the news myself and dad got on our arrival that evening.

We've lived with it ever since, with not much growth, but a couple of operations (Basingstoke). Most recently mum was admitted for Christmas (I think she just wanted me to have to cook lunch!! ) and then again a week or so ago. Both of these times have been with bowel problems (twisted bowel?) which have seemed quite nasty at the time, then she's ok-ish once the obstruction has gone and she is rehydrated again. We're a bit worried as the two episodes were quite close to each other and the doctors are not keen to open her up as they say this risks spreading the PMP.

Any advice anyone?

Rachel x

Posted By: Julie
Date Posted: 12 Feb 2008 at 7:40pm

Hello Rachel & Wendy

Welcome to our family! I am sorry I can't give you any advise re twisted bowel, but I am more than sure some of the others may have.

I look forward to reading lots more future posts from you & your mum!

Big Julie x

Posted By: Chrissie
Date Posted: 12 Feb 2008 at 9:06pm

Hi Rachel and Wendy

I have had PMP for over 10 years now.

From August 2007 to the end of October I had a twisted bowel on ten occasions. Sometimes twice in the same week, when it sorted itself out very quickly. The pain was dreadful for short periods and then eased a little. I could not keep anything down.

The longest I went was 52 hours. I called my GP out on that occasion. That's when I found out it was a twisted bowel. He told me that if I went longer than 72 hours I should get myself into hospital to be rehydrated. I spoke to our PMP doctor at Christie's. He said the same, but said if further intervention was needed I should ask the local hospital to ring Christie's.

I did not have another problem until January 9th. It lasted for 56 hours, though I did manage to keep some fluids down on the second night, before starting to be sick again.

Each time it takes a few days for me to recover and get my strength back. Then I just pray that it doesn't happen again for a while!

I think you have to remain positive and not think about it recurring.

Hoping you have no further problems.

Love Chrissie xxx

Posted By: maxine
Date Posted: 14 Feb 2008 at 9:29pm

Hi Rachel and Wendy

Welcome both to the family - I hope the twisted bowl gets sorted or starts to ease itself and that you are not in too much pain or discomfort.

Love Max

xx

Posted By: PECKY
Date Posted: 29 Feb 2008 at 2:53pm

Hi Chrissie,

i was reading your messages and didnt realise that so many other people are suffering with these symptoms.

i have just come out of hospital after being diagnosed with a twisted bowel, i went nine days without eating or drinking and had to be rehydrated, i couldnt keep anything down and the pain was severe.Being sick and wretching just seemed to aggrevate the pain. I am now on buscopan and mebeverine, these do seem to work but sometimes i feel like i could do with something else. i was so pleased i found you as i felt that i was alone and now i know that their is other people who will understand what its like thankyou Tracy

Posted By: Chrissie
Date Posted: 29 Feb 2008 at 9:21pm

Hi Tracy

Welcome to the site.

I really feel for you. 56 hours seemed like an eternity to me. Don't know how anybody could suffer for as long as you. Do you have frequent attacks?

I've still not been to see my GP. I used to take buscopan for my spastic colon and after each CT scan, which seemed to aggrivate my colon, but I can't say it ever did any good. I've not had mebeverine. Was this prescribed by the hospital or your GP?

I've looked at your profile, but there is no information. Are you also a patient at Christie's?

Looking forward to hearing more from you.

Love Chrissie xx

Posted By: PECKY
Date Posted: 01 Mar 2008 at 5:16pm

hi chrissie

i had an op for a herniated bowel last may and was admitted with similar symptoms last august but seemed to clear on its own. i was prescribed mebeverine by the hospital (they said it is a anti spasmodic). when the pain gets too bad it doesnt take it off fully it just numbs it slightly. i can eat small amounts but its when i do eat that the pain gets worse which makes me not want to eat at all. i am not a patient at christies as i live near hull.

Posted By: Chrissie
Date Posted: 01 Mar 2008 at 9:33pm

Hi Tracy

Thank you for the information. It has left me wondering if you have a bowel problem other than PMP. I live in Halifax, but as there are only two hospitals where PMP is treated, I go to Christie's as it is the nearest.

When I eventually go to the doctors I'll ask about the mebeverine. It's always good to know what has worked for others.

I don't have a problem with eating for much of the time, though I do try to avoid certain foods and food combinations. Obviously when an attack occurs, nothing stays down, not even fluids, and it takes a good few days for the body to return to normal.

Hope you are more comfortable now.

Love Chrissie xx

Posted By: Mary
Date Posted: 03 Mar 2008 at 10:29pm

Hi Wendy's daughter,

My daughter has PMP and was also admitted with suspected twisted bowel and now has to look at her diet very carefully, I know how helpless you feel especialy when they were putting in the nasal gastric tube I got thown out of the room!! but we are all here for you on the forum. We all keep each other going. Do not be afraid to post, you may even get your mum to learn I did and I am not that young.

Lots of love and be strong for yourself!

Mary

Posted By: Wendys Daughter
Date Posted: 04 Mar 2008 at 7:48am

Hi Mary,

Thankyou for your kind words. Mum is visiting at Easter so I shall make sure I get her online!!! You never know, she might like it and actually get herself a computer!!!

She is doing fine at the moment, and being carefull what she eats. Her MacMillan nurse had a good tip which seems to work - just prior to the blockages she tends to get the runs for a few weeks and the miracle answer in sorting it out is marshmallows! And it does actually work everyone!

Love Rachel

Posted By: Chrissie
Date Posted: 04 Mar 2008 at 10:31pm

Hi Rachel

I can't say I have any symptoms to warn me of a twisted bowel. Perhaps a marshmallow a day would keep the pain and sickness at bay! I shall have to try it.

Hope your Mum continues to feel well.

Love Chrissie xx

Posted By: Mary
Date Posted: 05 Mar 2008 at 10:20am

Dear All,

We could now invent the marshmallow diet and sell the book! Marshmallow trifle sounds good anyone esle has any ideas?

Lots of Love Mary

-------------Mary

Posted By: Wendys Daughter
Date Posted: 05 Mar 2008 at 10:41am

Howabout skewered marshmallows with jelly tots inbetween......... I can see a new cook book coming out!

Posted By: Mary
Date Posted: 05 Mar 2008 at 4:01pm

What about something with alcohol !!! a cocktail with mini marshmallows on top (pink of course!!!) you do have a problem sucking the marshmallows through the straw though, can get messy

Lots of love Mary xxxx

-------------Mary

Posted By: jessy
Date Posted: 05 Mar 2008 at 8:28pm

How about marshmellows with fruit pastiles in the middle set in jelly????

Jelly!!!!!!!!!!!!!

Posted By: shelly_187
Date Posted: 07 Apr 2008 at 3:47pm

I have just spent the weekend in tremendous pain in my abdomen, its hard to describe but sometimes it was like contractions and i had to breath through them, also when i sat down i got a shooting pain right through me,it is a little easier today although my tummy is very tender. Anyway just got back from Gp who said it sounds like a twisted bowel and if it happens again to just take fluids untill it passes and she has given me some antibiotics

-------------Shelly xxx

Love life.........

Posted By: shelly_187
Date Posted: 07 Apr 2008 at 3:50pm

Oh and im off to buy some marshmallows

-------------Shelly xxx

Love life.........

Posted By: Guests
Date Posted: 08 Apr 2008 at 5:37pm

Hi Shelly

just had a scan this am and the radiographer at PRH was asking after you!! sorry you have had a bad weekend - are you overdoing it?????

The docs and I eventually put my breathlessness down to scar tissue on the diaphragm after x rays and blowing stuff!! It did improve with swimming but now I'm on chemo it has got bad again as I can't do so much to challenge it.

Hope you are feeling better love Liz x

Posted By: shelly_187
Date Posted: 08 Apr 2008 at 7:05pm

Hi Lizi,

Was the rediographer someone I know? or just someone I met because of PMP? They are saying it is probably scar tissue too for me. Perhaps I should take up swimming. I am feeling a lot better thankyou although not 100% and Yes I probably am overdoing it. I hope the chemo regime isnt taking too much out of you. We will have to get together for coffee again soon.

-------------Shelly xxx

Love life.........

Posted By: Chrissie
Date Posted: 08 Apr 2008 at 9:35pm

Hi Shelly

Sorry to hear about the pain. I hope things are now easier for you.

Were you able to keep fluids down? When it happens to me, it's as if my stomach shuts down and nothing stays down for long.

I've tried the marshmallows, but don't know if they are working. Time will tell!

Love Chrissie xxx

Posted By: shelly_187
Date Posted: 08 Apr 2008 at 9:38pm

Hi Chrissie, I dont think I got it as bad as you, I felt sick but wasnt.

-------------Shelly xxx

Love life.........

Posted By: Guests
Date Posted: 09 Apr 2008 at 3:09pm

Hi there shelly

Not sure if it was due to PMP or something else I can't remember the lady's name either - some good I am!!

Am feeling a bit better today but still not really going out anywhere yet - hopefully I will feel up to going out on friday as I am meant to be meeting some friends for lunch.

don't do too much - the wellington pool is usually quite warm for a swim - i hate cold pools

love liz x

Posted By: Julie
Date Posted: 09 Apr 2008 at 3:21pm

Hello everyone I'm back!!

Soz I haven't posted for a while, I've have been having computer problems but thankfully its fixed now!

Sorry to hear that you haven't been feeling too well Shelly. You will have to take things a little easier you know and stop doing too much! A huge congratulations on your scan & bloods though petal, that is fantastic news

I keep on saying this but I don't suppose we have anymore info on our get together? This year seems to be rapidly getting by and I really hope that we do all manage to get together at some point!

Great big for you all.

Julie xx

Posted By: shelly_187
Date Posted: 09 Apr 2008 at 3:59pm

Thanks Julie.

Ive been thinking the very same, the year is flying by. It would be great to meet up somewhere, it doesnt need to be a huge affair.

-------------Shelly xxx

Love life.........

Posted By: Julie
Date Posted: 09 Apr 2008 at 4:10pm

I know Shelly

If nothing is sorted soon why don't we just arrange to meet? I would be more than willing to travel to your area if you source me somewhere to stay? Just a simple B&B or a caravan site and I will bring my caravan to stay in! Anyone else wanting to come feel free!

Julie

Posted By: shelly_187
Date Posted: 09 Apr 2008 at 4:14pm

Julie I am going to my friends caravan at a haven site near blackrock sands for the weekend on 25th April I know there are lots of camping and caravan sites there.

-------------Shelly xxx

Love life.........

Posted By: Julie
Date Posted: 09 Apr 2008 at 4:22pm

Hi Shelly

It is Ayla's birthday on the 24th and we are taking her away in the caravan for the weekend. We are meeting up with my parents in their caravan for a surprise! That's just typical isn't it!

Posted By: shelly_187
Date Posted: 09 Apr 2008 at 4:22pm

Aww never mind, worth a try.

-------------Shelly xxx

Love life.........

Posted By: Julie
Date Posted: 09 Apr 2008 at 4:25pm

Oh I won't give up that easily! There are plenty more days left this year! Where do you live? Do you have any caravan sites in your area? I am away to Spain on the 31st may for 2 weeks, but other that that I will be looking for weekends away with my caravan!

Posted By: shelly_187
Date Posted: 09 Apr 2008 at 4:26pm

I will google and look for you. I think there are some in Ironbridge where Lizi lives.

-------------Shelly xxx

Love life.........

Posted By: Wendys Daughter
Date Posted: 15 Apr 2008 at 3:56pm

Hello all, mum is typing over the phone with me so I have a message from her:

Hello everyone, I am getting a lot of pain when I lay down at night which feels as if there is pressure on my organs which is only relieved when I get up and move around. Does anyone else suffer this or have any helpful ideas other than marshmallows?

I am having my next CT scan and bloods in a months time, so don't know if they will find anything more than usual. I have just ordered Chrissie Daplyns book for some inspiration. Does anyone know of any other books?

Love Wendy

Posted By: rosie
Date Posted: 19 Apr 2008 at 3:01pm

Hi wendy.

This could be many things.wind or twisted bowel or the healing after surgery. i Don't know where you are at the moment ref treatment,but it would do no harm to phone mia for better advice.I can only tell you i suffered terribly with bowel pain after my first op and went through hell with it. I only got relief by walking around the bedroom. Sometimes it was trapped wind othertimes nothing seemed to help but time... You did not say if you had pain at these times??

chrissie has suffered a lot of similar problems.maybe she can help better . as for inspiration there is none better than this forum although it is rather quiet at the moment. or read my story and others at http://www.rosiesstory.co.uk - www.rosiesstory.co.uk .

love rosie xx

-------------Yesterday is history.
Tomorrow a mystery.
Today is a gift.
That's why it's called the present!
rosie xxx

Posted By: Chrissie
Date Posted: 19 Apr 2008 at 10:05pm

Hi Wendy and Rosie

I often feel pressure under my ribcage and try moving around to get more comfortable. Post op., which seems a long time ago now, almost four years, I did a lot of walking and that helped.

I must admit the only thing I can do when I get the twisted bowel pains is lie down. Sitting up is more uncomfortable and I do not have the energy to walk around. Fortunately I have been free of those pains for a good few days. Just hope I haven't spoken too soon.

Love Chrissie xx

Posted By: Guests
Date Posted: 21 Apr 2008 at 2:13pm

Hi the main caravan sites near us are along Much wenlock way below the edge - very pretty, the one nearer us is a permanent type site.

liz x

Posted By: Guests
Date Posted: 21 Apr 2008 at 2:16pm

Hi wendy and mum

on the christie web site there is a long list of what to eat and what not to!! I am now not eating any fibre to speak of and it has helped- may be worth having a look plus the other post from today re tablets may help too liz xxx

Posted By: Wendys Daughter
Date Posted: 25 Apr 2008 at 2:13pm

Hi ladies,

Thankyou for all of your advice. I do finf that I have to watch what I eat as I suffer a lot of bowel pain and wind, and also pain under my rib cage. I was diagnosed 4 years ago, and my last op was 18 months ago in Baisingstoke. The disease was too wide spread but low grade, so they removed what they could and gave me heated chemo. I am now scanned 4 monthly at Addenbrookes and seen yearly at Baisingstoke. I have had 4 hospital admittances since with twisted bowel/adhesions. They tell me the mitomycin chemo causes adhesions and this will be a problem.

It's good to chat to you all - I don't feel so alone in fighting it now.

Love Wendy

Posted By: Megs
Date Posted: 25 Apr 2008 at 10:32pm

Hi Wendy I suffer with pain under my rib cage on the left side, any tips on how to ease it. My PMP is also wide spread.

I had first surgery Nov 2006 where they removed what they could but I required follow up surgery Nov 2007 when my abdomen swelled so much it looked like I was carrying twins.

Surgery remove 14 litres of fluid mainly Ascities fluid.

My abdomen is now swelling again ,I had a scan yesterday and get results 1st May and hope that the fluid can be drawn off.

Not sure what to call this next set of twins!!!

Meirion

Posted By: Chrissie
Date Posted: 27 Apr 2008 at 10:09pm

Hi Meirion

My fluid started to build up within days of my debulking in 2003, when I had 10 litres of muscine removed. Fortunately it stopped growing in volume before it became painful. I don't think I could have coped with the intense pain again! I think they removed 6 litres when I was debulked at Christie's all but a year later.

I hope yours can be drawn off.

Good luck for Thursday.

Love Chrissie xx

Posted By: rosie
Date Posted: 27 Apr 2008 at 11:13pm

good luck brother.

in the background but watching your progress.

jeffers

-------------Yesterday is history.
Tomorrow a mystery.
Today is a gift.
That's why it's called the present!
rosie xxx

Posted By: Wendys Daughter
Date Posted: 30 Apr 2008 at 10:52am

Hi Merrion, I find that when I get pain under my ribcage I have to rest. Sometimes a hot water bottle helps. I find carrying things causes pain too. Good luck with your scan, I'm having mine on the 15th May. Let us know how you get on.

Love Wendy

Posted By: hellybobs
Date Posted: 27 Aug 2008 at 4:49pm

hi chrissie hope u r feeling better i had my op oct 2006 i get a lot of gurgling in my spare tyre ha ha and a little discomfort but did not no wat it was also av a lump wen i massage it it goes away is it all part of the disease take care xxxxxxxxxxxxxxx

Posted By: hellybobs
Date Posted: 16 Sep 2008 at 9:19pm

Hi everyone.

Am i right in saying that someone posted to say that they suffer a lot of gurgling in their stomach and their ribcage is misshapen on one side? Is this all part of the disease and or/operations?

Posted By: Guests
Date Posted: 17 Sep 2008 at 11:28am

Hi I have loads of gurgling still!! and my rib cage is flat but I can't inflate it as much as I would like to so walking up hill I get breathless.

Liz x

Posted By: Chrissie
Date Posted: 18 Sep 2008 at 5:17pm

Hi Helen

I won't say my ribcage is misshapen, but it has been pushed further out by the disease. It happened when I went from a size 12 to 20 in a matter of a few weeks in 2003.

I can't say I experience the gurgling now, but I certainly did before and after my last two ops.

Love Chrissie xx

Posted By: jessy
Date Posted: 18 Sep 2008 at 10:10pm

I still have a swelling just under my waistline and there are now certain things I cannot eat and drink. eg. shellfish and fizzy drinks.